We inspected Claremount House on 14 March 2017 and the visit was unannounced.

Claremount House is registered to provide accommodation, nursing and personal care for up to 26 people with mental health needs and people living with dementia. The accommodation is arranged over two floors and all of the bedrooms are singles with en-suite toilets. There are three comfortable lounge/dining areas on the ground floor and an accessible garden area for people to use.

On the day of the inspection there were 22 people using the service and two people were in hospital.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Our last inspection took place on 10 December 2015. At that time, we found the provider was not meeting the regulations in relation to dignity and respect and assessing and monitoring the quality of the service. We told the provider they needed to make improvements and found on this inspection the necessary improvements had been made.

We found staff were being recruited safely and there were enough staff to take care of people and to keep the home clean. Staff were receiving appropriate training and they told us the training was good and relevant to their various roles. Staff told us they felt supported by the registered manager and deputy manager and were receiving formal supervision where they could discuss their on-going development needs.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People who used the service and their relatives told us staff were loving, attentive and caring. We saw people were treated with respect and compassion. They also told us they felt safe with the care they were provided with. We found there were appropriate systems in place to protect people from risk of harm.

Staff knew about people’s dietary needs and preferences. People told us there was a choice of meals and the food was good. We also saw there were plenty of drinks and snacks available for people in between meals.

Care plans were up to date and risk assessments were in place and showed what action had been taken to mitigate any risks which had been identified. People who used the service and relatives told us they were happy with the care and support being provided. We saw people looked well groomed and well cared for.

People’s healthcare needs were being met and medicines were being managed safely.

Activities were on offer to keep people occupied both on a group and individual basis.

We saw there were systems in place to monitor the quality of the service. When areas for improvement had been identified action had been taken to address those shortfalls.

People who used the service were asked for their views and were able to influence the way the service was managed.

We inspected Claremount House on 10 December 2015 and the visit was unannounced.

Our last inspection took place on 20 January 2014 and, at that time, we found the regulations we looked at were being met.

Claremount House is registered to provide accommodation, nursing and personal care for up to 25 people with mental health needs. The accommodation is arranged over two floors there are two lounge/dining rooms and a quiet lounge on the ground floor and all of the bedrooms are single occupancy. At the time of our visit there were 24 people using the service.

There is a registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People who used the service told us they felt safe with the care they were provided with. We found there were appropriate systems in place to protect people from risk of harm.

Recruitment processes were robust and thorough checks were always completed before staff started work to make sure they were safe and suitable to work in the care sector. Staff told us they felt supported by the registered manager and that training was on offer.

There were enough staff on duty to make sure people’s care needs were met, people told us they liked most the staff and found them kind and caring. However, on our inspection we saw people were not always treated with dignity and respect. Activities and trips out were arranged to keep people occupied.

We found people had access to healthcare services to make sure their health care needs were met. Safe systems were in place to manage medicines so people received their medicines at the right times. We did identify problems with the Pharmacy dispensing medication in a timely way, which the registered manager was going to take up with the Clinical Commissioning Group.

We found the service was meeting the legal requirements relating to Deprivation of Liberty Safeguards (DoLS).

We found the home was well maintained bedrooms had been personalised and communal areas were comfortably furnished.

People told us if they needed to complain they would speak to the registered manager.

We found the organisation and leadership of the staff on the shift we saw was poor and resulted in people’s dignity being compromised.

We found some of the quality assurance systems were working well, but others needed to be improved to ensure people receive a consistent quality service.

We found two breaches of regulations and you can see what action we told the provider to take at the back of the full version of the report.

When we inspected the service in August 2013 we asked the provider to make some improvements. We went back on this visit to see what improvements had been made

During our visit we spoke with a number of people who lived at the home. Some people, due to their complex care needs, were not able to comment on their opinion of the service. Two people living in the home gave us their views and we spoke with two relatives and five members of staff. These are some of the things they told us:

“I like it here.”

“The staff are lovely.”

“The new manager has made changes for the better.”

“A lot of things have improved since the new manager started, it’s better for the people living here.”

We found people’s capacity to consent to care and treatment was being addressed through the care planning system. We found people’s care plans were up to date and easy to follow.

We found staff were telling us about incidents that happened in the home and were involving the safeguarding team appropriately.

The medication system was being managed safely and people’s care files were being brought up to date to make sure they reflected people’s current needs.

During our visit we spoke with a number of people who live at the home. Some people, due to their complex care needs, were not able to comment on their opinion of the service but three people and two visitors gave us the following comments:

“The staff are kind and help me with the things I need help with.”

“The food is smashing.”

“The activities organiser is very enthusiastic.”

“The home looks better than it did, but some of the furniture is starting to look shabby already.”

“I like the staff.”

During our visit we spoke with a number of people who lived at the home. Some people, due to their complex care needs, were not able to comment on their opinion of the service. Three people living in the home gave us their views and we spoke with four relatives and six staff. These are some of the things they told us:

“It’s lovely here.”

“The staff are very kind and the food is lovely.”

“I am very satisfied with the care my relative gets.”

“The activities person is very good and works really hard to involve people.”

“We have had a few problems, but think we are getting there now with our relatives care.”

“Some staff are better than others, some just seem to ignore people.”

We found that there was a nice atmosphere in the home and there were activities being provided during both morning and afternoon. We saw that people enjoyed the activities and were kept occupied and stimulated.

We saw that peoples’ care needs were met in a timely manner and that there were enough staff on duty to meet peoples’ needs, however, in the written care plans it was difficult to find up to date information about people’s current needs.

When we looked around some of the bedrooms we saw that peoples’ possessions were well cared for and rooms were very personal and homely.

We found that staff had not been reporting incidents to safeguarding or to ourselves as they should have been and the medication system was not being managed safely.